Nothing Was the Same by Kay Redfield Jamison Read Free Book Online Page B

intensified his childhood belief that science could do incomprehensible things.
    Richard caught the morning side of a fast-breaking wave in medical science, and he remained indebted to clinical scientists, especially Henry Kaplan, for the rest of his life. He regarded the nearly thirty years of life he had after his diagnosis of Hodgkin’s disease as a gift neither deserved nor undeserved, but an astonishing feat of medicine. He did not believe that the seeds of death left in him by the radiation were unjust. He knew what he owed to science, and he had an unassailable gratitude toward his doctors. Nothing changed those basic beliefs.
    Richard stayed well for twenty years. The second ten of these were ours, a decade of health that lulled us into believing that his past medical problems were truly past, not the determinant of our future. The next decade, however, defined more by illness than by health, established that the arrangement between his life and his death was a darker one. Kaplan’s treatment for Hodgkin’s disease had been brilliant but imperfect, as science at its frontiers so often is. Radiation, which cured Richard of his first cancer, was to come back three times: twice nearly to kill him and the third time to succeed.
    We knew such delayed damage was possible. Leukemias and other late-occurring cancers were not uncommon in patients treated with radiation; more recently, doctors had observed that a disturbing number of the Hodgkin’s patients who had been treated with high-dose radiation were also dying of “silent” heart disease. Because Richard had been a part of the early Stanford clinical trials, our internist ordered a cardiac stress test; it had to be stopped. The year before we got married, Richard was treated at Johns Hopkins for a 99. 9 percent blockage in his left anterior descending artery, a vessel subtly referred to by cardiologists as the “widow maker.” Four hospitalizations later, Richard’s heart was again hale and fit and, for a handful of years, he had an easy health. We were more wary than we had been before but thought, without thinking well, that we had paid our dues for his earlier survival of Hodgkin’s.
    It was never to be that easy. In the summer of 1999, fast and without warning, Richard got very sick. His weight plummeted and he found it hard to breathe. He no longer was the alert, intensely curious man I had fallen in love with; rather, he was dull and disinterested. I scarcely recognized him. Richard was fading away quickly, melting like the Wicked Witch, someone for whom, when he was well, Richard maintained a strong affection.
    The scans ordered by our internist revealed tumors in Richard’s liver, rectal wall, and lungs. No one tried to minimize this medical reality, although, in an unthinking moment of whistling past the graveyard, I mumbled something about the advances being made by our colleagues in oncology. This seemed improbable even as I said it. Richard looked at me incredulously: there was little hope against tumors strewn archipelago-like, so far and wide throughout his body. Richard and I were optimists by nature, but not insensate.
    Neither of us slept that night, reaching out for each other, troubled and restless: talking, silent; lights on, lights off; looking through Richard’s old medical textbooks—hopelessly out of date in their discussions of cancer—to find a phrase or a statistic that might dampen the horror for a while. We went through every “What if?” we could imagine—and we could imagine many—and then drew into our collective self, coiled around each other in some ancient mammalian way to fend off desperation.
    The next day was better, in part because it was the day and not the night, and in part because it was not possible for it to be worse. Richard’s preliminary biopsy results offered us some hope, as well; it was possible that Richard had lymphoma, not metastatic solid tumor disease. Lymphoma, in our new world of bad options,